Place and Underlying Cause of Death During the COVID-19 Pandemic: Retrospective Cohort Study of 3.5 Million Deaths in England and Wales, 2014 to 2020

Autor: Mamas A. Mamas, Jianhua Wu, Muhammad Rashid, Mark A de Belder, M Mafham, Chris P Gale, John E. Deanfield, Evangelos Kontopantelis
Rok vydání: 2021
Předmět:
Male
COVID-19/diagnosis
Underlying cause of death
Nursing Homes/statistics & numerical data
Disease
030204 cardiovascular system & hematology
0302 clinical medicine
Cause of Death
Neoplasms
Pandemic
Hospital Mortality
030212 general & internal medicine
ONS
Office for National Statistics UK
Wales/epidemiology
Cause of death
Aged
80 and over
Hospital Mortality/trends
Excess mortality
R735
ICD-10
General Medicine
Middle Aged
Home Care Services
England
Original Article
Female
Neoplasms/mortality
Adult
medicine.medical_specialty
Heart Diseases
Coronavirus disease 2019 (COVID-19)
Diagnostic Errors/mortality
Cause of Death/trends
03 medical and health sciences
RZ
medicine
Humans
Hospice Care/statistics & numerical data
Diagnostic Errors
England/epidemiology
Mortality
Wales
SARS-CoV-2
business.industry
Heart Diseases/mortality
ICD-10
International classification of diseases 10th version
COVID-19
Retrospective cohort study
Nursing Homes
COVID-19
Coronavirus disease
Hospice Care
Death toll
Home Care Services/statistics & numerical data
Emergency medicine
Medical certificate
business
RA
NHS
National Health Service UK
Demography
Zdroj: Wu, J, Mafham, M, Mamas, M A, Rashid, M, Kontopantelis, E, Deanfield, J E, de Belder, M A & Gale, C P 2021, ' Place and Underlying Cause of Death During the COVID-19 Pandemic : Retrospective Cohort Study of 3.5 Million Deaths in England and Wales, 2014 to 2020 ', Mayo Clinic Proceedings, vol. 96, no. 4, pp. 952-963 . https://doi.org/10.1016/j.mayocp.2021.02.007
Mayo Clinic Proceedings
ISSN: 0025-6196
1942-5546
DOI: 10.1016/j.mayocp.2021.02.007
Popis: BackgroundThe COVID-19 pandemic has resulted in a high death toll. We aimed to describe the place and cause of death during the COVID-19 pandemic.MethodsThis national death registry included all adult (aged ≥18 years) deaths in England and Wales between 1st January 2014 and 30th June 2020. Analyses were based upon ICD-10 codes corresponding to the underlying cause of death as stated on the Medical Certificate of Cause of Death. Daily deaths during COVID-19 pandemic were compared against the expected daily deaths estimated using Farrington surveillance algorithm for daily historical data between 2014 and 2020, by place and cause of death.FindingsBetween 2nd March and 30th June 2020, there was an excess mortality of 57,860 (a proportional increase of 35%) compared with the expected deaths, of which 50,603 (86.2%) were COVID-19 related. Almost half the excess deaths occurred in care homes (25,611 deaths) where deaths were 55% higher than expected. One fifth of the excess deaths occurred in hospital (15,938 deaths; a proportional increase of 21%) with the remainder occurring at home (16,190 deaths; a proportional increase of 39%). At home, only 14% of 16,190 excess deaths were related to COVID-19, with 5,963 deaths due to cancer and 2,485 deaths due to cardiac disease, very few of which involved COVID-19. In care homes or hospices, 61% of the 25,611 excess deaths were related to COVID-19, 5,539 of which were due to respiratory disease and most of these (4,315 deaths) involved COVID-19. In hospital, there were 16,174 fewer deaths than expected which did not involve COVID-19, and there were 4,088 fewer deaths due to cancer and 1,398 fewer deaths due to cardiac disease than expected.InterpretationThe COVID-19 pandemic has resulted in a substantial increase in the absolute numbers of deaths occurring at home and care homes. There was a huge burden of excess deaths occurring in care homes, which were poorly characterised, and were likely to be, at least in part, the result of undiagnosed COVID-19. There was a smaller but important and ongoing excess in deaths at home, particularly from cancer and cardiac disease, which suggests avoidance of hospital care for non-COVID-19 conditions.FundingThe study is unfunded.
Databáze: OpenAIRE
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